Saving Eyes, Saving Vision

A Neurosurgeon and an Oncologist Join Forces to Treat a Childhood Eye Cancer

IN 2011, LEANNE DAVIS, a new mom and high school English teacher from Warren, Mich., took her 4-month-old son Cole with her to her regular eye exam.

As a child, Leanne had retinoblastoma, a rare and potentially deadly cancer of the eye. She had an eye removed to cure her cancer. Suddenly, her worst fears were confirmed: Cole was showing early signs of the same disease.

Put yourself in Leanne’s shoes. Imagine the most difficult thing that ever happened to you, happening to your child. You would do anything to heal them.

Retinoblastoma grows in the eye’s light-sensing retina. In the United States, just 300 children develop this malignancy annually. Until recently, about 40-50 percent of kids with advanced retinoblastoma lost one eye, and around 10 percent lost both eyes despite aggressive therapies; the rate was higher for those with the most severe disease.

Cole’s cancer was stubborn. It re-appeared despite 21 rounds of chemotherapy, laser photocoagulation, radiation and cryotherapy in various combinations. But the Davis family and their doctors in Detroit and Philadelphia were even more persistent.

When a new tumor the size of a blueberry was discovered in the boy’s right eye in October 2014, Leanne and her husband, Clint, left their home in Michigan and turned to a breakthrough therapy known as Intra-Arterial Chemotherapy (IAC) at Jefferson.

Dr. Carol Shields, an ophthalmology professor at Jefferson and co-director of Ocular Oncology at Wills Eye Hospital calls IAC “one of the biggest breakthroughs in eye cancer of the past two decades.” Jefferson is one of just two places in the country that offers it.

“In the recent past, many children lost their eyes to this disease,” says Pascal Jabbour, MD, associate professor of neurological surgery and chief of the Division of Neurovascular and Endovascular Neurosurgery. “Now we are saving 62-72 percent of eyes with advanced retinoblastoma thanks to IAC at Jefferson — and 100 percent in earlier stages of the cancer.”

IAC relies on a unique partnership between physicians with finely honed, yet very different skill sets. An oncologist must carefully assess the cancer’s progress in each tiny patient to identify the right candidates. A neurosurgeon must thread a micro-catheter through fragile, whisper-thin arteries from a child’s groin to eye, then deliver a high-dose chemotherapeutic agent in carefully timed puffs.

"Saving life is always the first priority, followed by saving the eye and then saving vision.

We’ve doubled the number of eyes we can save, compared to other treatments,” says Shields. “And we’re seeing early evidence that it can restore peripheral and even central vision in some patients. I hear from happy parents all the time. Their kids were on the brink of blindness. Now they’re stacking blocks, doing puzzles, playing T-ball. It’s so exciting.”

By January 2015, Jabbour and Shields had used IAC to treat more than 150 cases of retinoblastoma from across the nation and around the world, including Cole, whose vision was saved.

“The yellowish glint we saw in his eyes sometimes is gone,” says Cole’s dad Clint Davis, a high-school chemistry teacher. “Cole’s playing with his trucks, watching his favorite Mighty Machines TV show and doesn’t have to lean forward to see the pictures when I read to him anymore.”